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Public opinion and trust in government during a public health crisis

VIVIENNE MOXHAM-HALL and LUCY STRANG: Transparency and open communication will be important in overcoming coronavirus

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In times of crisis, knowing what people think is important – and particularly so during a pandemic, when the success or failure of the response depends on radically changing public behaviour and getting them to know, trust and follow government advice. Following the coronavirus outbreak, pollsters have rushed to track these changes, as well as the broader social and political implications for the UK.

So what effects have we seen so far?

Crises such as this tend to underscore the importance of leadership, and can produce what is known as a “rally around the flag” effect, whereby political leaders experience a spike in public approval. The coronavirus crisis is no different: since early March, as the government begun introducing new social distancing measures, Prime Minister Boris Johnson enjoyed a 17-point increase in his approval rating, which rose to 51 per cent.

There are two possible explanations that are usually offered for this effect. The first is that there is a temporary reduction in open criticism of the government as a result of the crisis, leading the public to assume that there is consensus among political leaders. The second is that there is an increased sense of patriotism and people feeling like the nation should band together.

Both of these factors seemingly came together for US President George W Bush, who experienced a record 35-point increase in support in the four days following the terrorist attacks on 11 September, 2001.  

As the coronavirus crisis continued through March, approval ratings for the Conservative party continued to increase even further, reaching heights not seen since 2016, while public support for the government’s handling of the crisis was around 72 per cent.

However, it’s a different story when it comes to how much the public trust the government during this crisis. Many polls have found that trust in the government’s communications around Covid-19 has not experienced the same highs, with only 42 per cent of the public saying they trust the information provided by Boris Johnson on coronavirus, and 50 per cent saying they trust politicians more broadly.

Indeed, with public trust on coronavirus in the UK, it seems people are rallying less around the flag and more around the health system. Polling has shown overwhelming public trust in subject experts or practitioners as sources of information about Covid-19: 89 per cent trust health officials to give them reliable information, closely followed by scientific experts (85 per cent) and official government advisors such as the Chief Medical Officer and Chief Scientific Adviser (84 per cent).

Commonly with rally around the flag effects, support wanes after a period of time. And we are already seeing the first dip, with approval for Boris Johnson and his team decreasing to between 45 and 48 per cent in mid-April.

What does trust in government mean for compliance and behaviour change?

In polling conducted by the Policy Institute in partnership with Ipsos MORI, we found those who indicated that they trusted the government to control the spread of coronavirus were slightly more likely to follow the rules imposed during lockdown.

We also found that those who say they don’t trust the information provided by the government on coronavirus were 10 percentage points more likely to believe that Covid-19 was probably created in a laboratory. And those who believe this conspiracy theory are significantly less likely to comply with the lockdown rules to the same extent as those who do not: less than half – 48 per cent – of those who believe it say they have complied with the lockdown measures completely or nearly all the time, compared with 98 per cent among people who do not believe the virus was developed in a lab.

Furthermore, people who do not trust the government to handle the outbreak, or who do not trust the information being provided by the government, were more than twice as likely to say the government’s response to Covid-19 had been confused and inconsistent.

In the context of compliance with public health orders and policies, evidence suggests that public trust in government is critical. This is especially the case when compliance is voluntary, such as with vaccination programmes, or simply required at such a scale that enforcement in the face of widespread non-compliance would be hugely challenging – such as measures imposed to deal with a virus outbreak.

In 2014-15, Ebola spread rapidly in Liberia, an event that was found to be exacerbated not only by an ineffective government response but also a lack of trust by citizens suspicious about the source and spread of the virus and who resisted even simple precautions such as regular handwashing. The hardships experienced during the crisis damaged trust in government even more, turning the epidemic “from a health crisis into a governance crisis”.

The public health effects of mistrust in government have also been documented in the UK: lower MMR vaccine coverage, beginning in the late 1990s, has been linked to lower levels of trust following the government’s lack of transparency around BSE, or mad cow disease. Experiences and historical legacies of racism and other forms of mistreatment in the healthcare system have also been linked to mistrust in public health officials and beliefs in conspiracy theories around HIV/AIDS.  

How can governments maintain trust and compliance in a public health crisis?

As we enter the second month of lockdown, maintaining trust in the decision to continue with these restrictions will be key to fighting the inevitable fatigue and subsequent decrease in public adherence to the “stay home” directives. Already, we know that 15 per cent of people in the UK are finding the lockdown measures extremely difficult, and as we enter the five- to eight-week period, there will be more people finding it increasingly hard to stay inside. Our polling indicated that on top of the 15 per cent already finding it difficult, another 14 per cent believe it will become extremely difficult for them by mid-April, and another 12 per cent more by May – that’s 41 per cent of UK residents struggling to stay in lockdown.

A key strategy that the government has been using in their communications is the positioning of public health officials to bolster the public trust and support of government directives and emphasising that the measures are evidence-led. Additionally, government outreach efforts towards existing social and civil society networks and institutions have been found to promote compliance and increase trust in government in public health crises.

The SARS crisis of 2003 also demonstrated the importance of transparency and timely, accurate and open communication. Above all, trust in government is a long game. The government is grappling with the legacy of decades of successes and failures in public health policies. How it manages the current crisis will be a determining factor in public trust and compliance when the next one emerges.

Vivienne Moxham-Hall and Lucy Strang are Research Associates at the Policy Institute, King's College London.